Z-plasty
Encyclopedia
Z-plasty is a plastic surgery
Plastic surgery
Plastic surgery is a medical specialty concerned with the correction or restoration of form and function. Though cosmetic or aesthetic surgery is the best-known kind of plastic surgery, most plastic surgery is not cosmetic: plastic surgery includes many types of reconstructive surgery, hand...

 technique that is used to improve the functional and cosmetic appearance of scar
Scar
Scars are areas of fibrous tissue that replace normal skin after injury. A scar results from the biological process of wound repair in the skin and other tissues of the body. Thus, scarring is a natural part of the healing process. With the exception of very minor lesions, every wound results in...

s. It can elongate a contracted scar or rotate the scar tension line. The middle line of the Z-shaped incision (the central element) is made along the line of greatest tension or contraction, and triangular flaps are raised on opposite sides of the two ends and then transposed. The length and angle of each flap are usually the same to avoid mismatched flaps that may be difficult to close. Some possible complications of Z-plasty include flap necrosis, haematoma (blood clot) formation under the flaps, wound infection, trapdoor effect and sloughing (necrosis) of the flap caused by high wound tension.

Technique

The transposition of two triangular flaps. The incisions are designed to create a Z shape with the central limb aligned with the part of the scar that needs lengthening or re-aligning. The traditional 60° angle Z-plasty will give a theoretical lengthening of the central limb of 75%. Single or multiple z-plasties can be used. Specific modifications include the double-opposing z-plasty (sometimes called a "jumping man") which can be useful for release of webbing of the medial canthus or release of 1st web space contractures.

Functional Z-plasty

The lengthening of a scar. Used to help relax or release linear burn scar contractures. The technique is dependent on the availability of mobile adjacent skin.

Cosmetic Z-plasty

The irregularisation of a scar to make it less noticeable. Re-alignment of the central element can place the scar in natural skin tension lines and thereby disguise it. One of a family of similar techniques (such a W plasty).

External links

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